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IVC Spring 2021
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THE LATEST ON THE LINK BETWEEN CANINE DILATED CARDIOMYOPATHY AND NUTRITION
By Dr. Barbara Royal, DVM, CVA Misinformation about the causes of DCM in dogs is still being spread. In this article, we will examine the current body of evidence for hearthealthy nutritional decision-making.
NUTRITION NOOK PET FOOD MATH
By Dr. Karen Gellman, DVM, PhD
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TREATING LYME DISEASE IN THE HORSE
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INCORPORATING WHOLE FOOD NUTRITION INTO YOUR VETERINARY PRACTICE
How to decipher pet food labels and why it’s so important.
CLINICAL UTILITY OF C-REACTIVE PROTEIN AND THE C-REACTIVE PROTEIN/ALBUMIN RATIO (CAR) IN CANINE PATIENTS By Marlene Siegel, DVM, ALT, CNHP
A NEW FRAMEWORK FOR CHRONIC GI DISEASE IN DOGS AND CATS
By Katherine E. Dahlhausen, PhD, Dawn D. Kingsbury, DVM, PhD, DIP. ACVIM (SAIM), and Holly H. Ganz, PhD Chronic enteropathy (CE) is the term now used to describe long-term gastrointestinal disease that lacks a specific diagnosis in canine and feline patients.
LIMITED INGREDIENT DOG FOOD
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by Gary Tashjian
NUTRITIONAL SUPPORT FOR THE AGING CANINE BRAIN By Valarie V. Tynes, DVM, DACVB, DACAW
Dogs are living longer than ever. However, this increases their risk of developing cognitive dysfunction syndrome (CDS). Here’s how nutritional support can help.
THE BENEFITS OF BOTANICALS IN CANINE BEHAVIOR MANAGEMENT
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By Joyce Harman, DVM, MRCVS While treating Lyme disease in horses is complex, a wide variety of alternative therapies can be helpful for different stages and manifestations of the illness.
By Oscar Chavez, BVetMed, MRCVS, MBA
Published research supports the health benefits of human-grade, whole food nutrition for dogs and cats.
MICROBIOME RESTORATIVE THERAPY (MBRT) FOR PANCREATITIS AND OTHER GI ISSUES
By Margo Roman, DVM, CVA, COT, CPT
PHARMACY VS. FARMACY By Marlene Siegel, DVM
How nutrient deficiency, toxicity, and lifestyle are making veterinary patients more dependent on the pharmacy medical model.
INNOVATIVE PRACTICE
TEACHING CLIENTS TO SHINE THE LIGHT OF BEAM ON THEIR PETS’HEALTH
By Christina Chambreau, DVM, CVH Short for Behavior, Energy, Appetite, and Mood, BEAM shifts the client’s focus from current symptoms to a more comprehensive view of the pet’s quality of life.
DEER VELVET ANTLER — APPLICATIONS IN THE VETERINARY SETTING
By Julie Buzby, DVM, CVA, CAC Studies are demonstrating that deer velvet antler has a long, impressive, and rapidly-growing list of positive benefits.
By Amanda Ardente, DVM, PhD
THE EVOLUTION OF GUT HEALTH — PART 1 By Julie Anne Lee, DCH, RCHom
FOR AN ANIMAL’S HEALTH AND HOMEOSTASIS, LOOK TO THE RENAL PROXIMAL TUBULE
By John J. Gildea, PhD, Jiqian Huang, MD, PhD, and Zach Bush, MD
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advisory board Dr. Richard Palmquist, DVM GDipVCHM(CIVT) CVCHM (IVAS), graduated from Colorado State University in 1983. He is chief of integrative health services at Centinela Animal Hospital in Inglewood, California, former president and research chair of the AHVMA, and an international speaker in integrative veterinary medicine. Dr. Palmquist is a consultant for the Veterinary Information Network (VIN) and a past president of the AHVM Foundation. He has published two books, one for conventional veterinarians and a second for clients discussing how integrative thinking works. Michelle J. Rivera, MT, VDT, is an instructor at the University of Wisconsin and The Healing Oasis Wellness Center, a post-graduate educational institution offering state-approved programs. She is co-owner of The Healing Oasis Veterinary Hospital, offering massage, rehabilitation, chiropractic and Chinese and Western Herbology. Michelle completed the Chinese Herbal Medicine program from the China Beijing International Acupuncture Training Center, and is certified in Chinese Medicine by the Wisconsin Institute of Chinese Herbology.
29 COLUMNS & DEPARTMENTS
6 Editorial 36 Industry innovations 38 From the VBMA 55 From the AHVMA 56 From the NASC 61 From the AVH 65 From the VMAA 66 News bites
Dr. Joyce Harman, DVM, MRCVS, graduated in 1984 from Virginia Maryland Regional College of Veterinary Medicine. Her practice is 100% holistic, using acupuncture, chiropractic, herbal medicine and homeopathy to treat horses to enhance performance and those with a variety of chronic conditions, with an emphasis on Lyme Disease. Her publications include the Pain Free Back and Saddle Fit Books, and numerous articles in lay and professional magazines. She maintains an informative website: www.harmanyequine.com. Dr. Steve Marsden, DVM, ND, MSOM, Lac. Dipl.CH, CVA, AHG lectures for IVAS, the AHVMA, the AVMA, and numerous other organizations. He is co-founder of the College of Integrative Veterinary Therapies and is a director emeritus of the National University of Natural Medicine in Portland OR. He authored the Manual of Natural Veterinary Medicine (Mosby); and Essential Guide to Chinese Herbal Formulas (CIVT). Dr. Marsden is extensively trained in alternative medicine, including Chinese herbology, acupuncture and naturopathic medicine. He has holistic veterinary and naturopathic medical practices in Edmonton, Alberta. In 2010, Dr. Marsden was named Teacher of the Year by the AHVMA; and Small Animal Veterinarian of the year by the CVMA in 2009. Dr. Jean Dodds, DVM, received her veterinary degree in 1964 from the Ontario Veterinary College. In 1986, she moved to Southern California to establish Hemopet, the first non-profit national blood bank program for animals. Dr. Dodds has been a member of many national and international committees on hematology, animal models of human disease, veterinary medicine, and laboratory animal science. She received the Holistic Veterinarian of the Year Award from the AHVMA in 1994.
Dr. Barbara Fougere, DVM, CVAA graduated in 1986, and was named the American Holistic Veterinary Medical Association Educator for 2011. Dr. Fougere is the principal and one of the founders of the College of Integrative Veterinary Therapies. She has continued studying over the last 26 years, and has three Bachelor degrees, two Masters degrees, three post Graduate Diplomas, several Certifications and numerous other courses under her belt.
Dr. Christina Chambreau, DVM, CVH, graduated from the University of Georgia Veterinary College in 1980. She is a founder of the Academy of Veterinary Homeopathy, was on the faculty of the National Center for Homeopathy Summer School and has been the holistic modality adjunct faculty liaison for the Maryland Veterinary Technician Program and is the former Associate Editor of IVC Journal. Dr. Chambreau teaches classes in homeopathy for animals, lectures on many topics, speaks on Radio and TV, and is the author of the Healthy Animal’s Journal among other titles. She is now on the faculty of the Holistic Actions Academy, which empowers members to keep their animals healthy with weekly live webinars.
IVC Winter 2020/2021
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Our growing knowledge of canine health and nutrition, combined with other advances in medical science and technology, means dogs are living longer than ever. However, this longevity increases their risk of developing cognitive dysfunction syndrome (CDS). Here’s how nutritional support can help.
Nutritional support FOR THE
aging canine brain Cognitive decline, or cognitive dysfunction syndrome (CDS), is a neurodegenerative condition resulting from brain pathology, so is different from what is considered the normal aging process. The condition is progressive and irreversible, and will eventually result in behavioral changes related to learning, memory, perception, awareness, social interactions and activity level.1 Changes in sleep-wake cycles and feeding and drinking behavior, as well as altered responses to stimuli, often result.1 CDS has been shown to be an excellent model of the aging process associated with Alzheimer’s disease in humans.2
AGING CHANGES THE BRAIN Several gross anatomical changes can be seen as the brain ages; total brain volume decreases and ventricular volume increases.2-5 Specifically, frontal cortex volume decreases and hippocampal volume can be seen to decrease as well.2-5 Since the hippocampus is associated with memory storage, one can see why memory deficits are associated with this condition. Changes that can be seen at the histopathological
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IVC Spring 2021
BY VALARIE V. TYNES, DVM, DACVB, DACAW
level include reduced numbers of neurons and an increased presence of free radicals.2,4 Free radicals are the normal by-products of cellular metabolism; under normal conditions, free radical scavengers remove these by-products. With age, the levels of free radical scavengers decrease, allowing free radical numbers to increase. The brain is extremely sensitive to the toxic effects of free radicals. Several other conditions associated with aging, such as heart disease and hypertension, result in decreased oxygen to the brain and contribute to the overall decline in brain tissue health. Other circulatory changes, including the increased presence of micro-hemorrhages and infarcts, further contribute to the clinical signs. 2,4 A reduction in glucose metabolism in the aging brain can lead to energy deprivation, which subsequently contributes to a further decrease in neuronal function.6 A reduction in cholinergic function has also been documented in the aging brain, and is suspected to contribute to the declining cognitive and motor functions seen in many aging individuals.7
Possibly one of the most notable changes is the increased presence of lipofuscin and beta amyloid plaques in the brain.2-5 Beta amyloid is also known to be neurotoxic and is a hallmark of Alzheimer’s disease in humans. The degree of accumulation of these plaques has clearly been associated with the degree of cognitive impairment in both humans and dogs.8
DIAGNOSING CDS CDS can be challenging to diagnose but the clinician should start by using the acronym DISHAA to evaluate the patient for signs of CDS.1 DISHAA stands for Disorientation, Interactions, Sleepwake cycle, House-soiling, Activity and Anxiety. See Table 1 for details regarding the DISHAA signs. Many of the signs commonly seen with CDS, such as house-soiling, nighttime waking and vocalization, and increased anxiety can be due to other medical conditions. For example, sleep-wake cycles are often altered in patients with chronic pain. The presence of osteoarthritis can make it difficult to lie down and stand up. Alternatively, lying
down for an extended period of time may lead to increased discomfort due to joint disease. Osteoarthritis can also lead to house-soiling if accessing the appropriate elimination site is painful for the dog. Any medical condition leading to increased frequency or urgency of elimination can result in house-soiling. Chronic pain can also lead to increased anxiety. As you can see, many signs of CDS can overlap, and many can be similar to those seen with other physical conditions. This means a good history, physical exam, and appropriate diagnostics are also important to rule out the presence of concurrent medical conditions. To some extent, CDS is a diagnosis of exclusion, but it is also likely to occur alongside many other medical conditions. All the pet’s medical conditions will need to be managed at the same time as the CDS is addressed, in order to maintain the best quality of life for the patient. Unfortunately, many pet owners may see these signs and just think their dogs are “getting old”, when in fact, if diagnosed early, many of these conditions can either be treated or managed so the Continued on page 31.
TABLE 1 – The signs of Cognitive Dysfunction Syndrome DISORIENTATION
• Acts as if they do not recognize familiar individuals • Stares blankly into space • Acts lost in home or yard • Gets stuck — can't figure out how to move around objects; stands at the hinge side of the door
INTERACTIONS
• Less interested in interacting with familiar individuals • More irritable • Increased attention seeking
(Changes in social interactions)
SLEEP-WAKE CYCLE • Sleeping more or less than usual •P acing, vocalization at night DISTURBANCES HOUSE-SOILING (Learning and memory problems)
ACTIVITY (Changes in level or frequency of activity)
ANXIETY
• Indoor elimination; decreased signaling to go outside • Failure to respond to previously learned cues • Less interest in play or walks • Increase in repetitive behaviors or aimless behaviors such as circling, pacing, etc. • Increased reactivity to stimuli • Increased anxiety when separated from owners • Increased fear or anxiety associated with new places or things
What the studies show Both the severity and prevalence of CDS increase with age in dogs. In one study of 180 dogs, 10% of 11-12-yearold dogs had two or more signs of CDS, while 36% of 15-16-year-old dogs had two or more.9 In another study of 479 dogs, using a newly validated questionnaire, 41% of dogs over 14 were affected.10 In a more recent study that involved prospective screening, prevalence ranged from 13% to 16% in dogs 8-11 years of age while almost all dogs over 13 showed some signs of CDS.11 The prospective study also found that over the course of six months, 42% of dogs with no impairment progressed to mild impairment, and 24% with mild impairment progressed to moderate.11 Over a year’s time, 71% progressed from having no signs to mild signs, and 50% progressed from moderate to severe signs.11 This suggests that twice-yearly screening could be extremely valuable, since most of the interventions that have been studied are most effective when used before signs of CDS become severe.
DISHAA: Recognizing signs of CDS
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